Sleep-disordered breathing and daytime napping are associated with maternal hyperglycemia

Abstract

Objectives: Sleep disturbances in pregnancy may impair glucose mechanism. This study aimed to examine associations of sleep-disordered breathing, sleep, and nap duration with 1-h glucose challenge test (GCT) levels in pregnant women after controlling for known risk factors for gestational diabetes. Method:s This is a case-control study of 104 pregnant women. All women underwent full polysomnography and a GCT and completed the multivariable apnea prediction and Pittsburgh Sleep Quality indexes. The primary outcome was maternal hyperglycemia measured by GCT. Bivariate and multivariable logistic regression analyses were performed. Results: Over 13 % subjects reported habitual snoring in the first trimester. Only 9.3 % women with normoglycemia (GCT<135) were habitual snorers, whereas 45.5 % women with hyperglycemia (GCT≥135) had habitual snoring (p< 0.001). Sleep-disordered breathing symptoms (loud snoring, snorting/gasping, and apneas) (odds ratio (OR) 2.85; 95 % confidence interval (CI) 1.50-5.41; p=0.001) and total nap duration (OR 1.48; 95 % CI 0.96-2.28; p=0.08) were associated with hyperglycemia. After adjusting for confounders, sleep-disordered breathing symptoms (OR 3.37; 95 % CI 1.44-8.32; p=0.005) and nap duration (OR 1.64; 95 % CI 1.00-2.681.02; p=0.05) continued to be associated with hyperglycemia. However, the primary exposure measure, the apnea/hypopnea index in the first trimester was not significantly associated with hyperglycemia (OR 1.03; 95 % CI 0.83-1.28; p=0.77). Conclusion:s Sleep-disordered breathing symptoms and nap duration are associated with hyperglycemia. Sleep duration was not associated with hyperglycemia. Research is needed concerning whether women with sleep-disordered breathing and/or daytime napping are at risk for gestational diabetes. © Springer-Verlag Berlin Heidelberg 2013.